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I used Claude Code to get a second opinion on my MRI

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Re: I used Claude Code to get a second opinion on my MRI

#251

Post by braiamp »

linsomniac wrote: post #91

~2 years ago I used ChatGPT "deep research" to investigate a chronic sinus infection I'd been fighting for ~3 years. After seeing 3 GPs and 3 visits with an ENT, I fed all the observations I had into the AI. In particular, I couldn't get the ENT to explain why he visually saw, via a scope, evidence of allergic reaction in my sinuses, but then later concluded, after an allergy test, that it couldn't be treated via all…

Ok, there's a lot to unpack here and you really had the deck stacked against you. First, lets go from the top, once a test says X, disproving that X is really hard. And that's not unique to the medical profession, it's inherent to all humans and we suck at revisiting or revising our decisions, much less at looking at the possibility to even reverse it.

Which moves us to the next two issues: liability and time. Any moment that you ask someone to revise a decision and specially with the stakes that the medical profession has that nobody has the time nor the inclination to open themselves for a mess.

Now, if you really want to be successful, you have to, before they even have a case with you, and specially before the diagnostic loop closes, to suggest the tests that the study has, since that has the biggest chances of looking at the right thing to look. Just be straight that you walked in with a theory. Doctors notice when they're being steered way faster than they notice when you're actually right. That's how you work with the systems that have a overworked mass trying their best.

Re: I used Claude Code to get a second opinion on my MRI

#252

Post by ForceBru »

operatingthetan wrote: post #220
singpolyma3 wrote: post #210

Earlier quoted context omitted.

That presumes that we have a definition of "thinking" or that we know that anything is "thinking" when in fact neither is true. The problem is real but I don't think positing a philosophical root is helpful

The claim that we are assigning human-like agency to a machine with none is simple and factual.

What's "thinking"? What's "agency"? What's "human-like agency"?

If "agency" is making decisions and performing corresponding actions in the real world, then LLMs most definitely LOOK LIKE they're making decisions (what's the next token? which tool to use? what's to say, in general? what idea to convey?) and performing actions (tool use). Can we tell whether they are ACTUALLY making decisions? Well, are the people around me "actually" making decisions? Or are they simply pushed around by circumstances and external forces?

Am I actually making decisions? Did I like DECIDE to write this comment? Maybe? I have no clue...

Re: I used Claude Code to get a second opinion on my MRI

#253

Post by Eji1700 »

backtoyoujim wrote: post #242
sxg wrote: post #6

I'm a radiologist but can't really weigh in without seeing the full 3D MRI dataset. Regarding this point: > They performed shockwave therapy on my shoulder even though a recent clinical practice guideline says clinicians should not use or recommend shockwave therapy for rotator-cuff tendinopathy without calcification; I was told during ultrasound that there was no calcification. Ultrasound isn't a great way to assess…

Does radiology really make +$700,000.00 a year ? Someone on reddit claiming to be a radiologist claimed that. I wonder where the savings will go when those jobs are gone.

> Does radiology really make +$700,000.00 a year ?

The radiologist I know does not, but they are paid very well (and these numbers are always dumb when you're not sure if they're living in Manhattan vs literally anywhere in Kentucky)

Like most medicine, a large % of the job could be done by any decently talented person willing to follow instructions and shadow for a few months.

Like most medicine, the remaining % is what you're paying for, because it is literally life and death and you can't do things like "pull the logs" or "lets turn it off and take it apart" or "huh i need to put this down and come back later". Even in radiology, because "well lets just do it again to be sure" is often not a viable option.

While there is a problem in how we have inflated the cost of education for medical fields, the insane health insurance issues (US obviously, but it does have some effect globally when the expert radiologist you hire from the US to help with research costs that much), and probably some better ways to approach splitting the work for the entire field, like most professions dealing in life or death, medicine likely will always be paid well.

Re: I used Claude Code to get a second opinion on my MRI

#254

Post by rasmus1610 »

lostlogin wrote: post #139
rasmus1610 wrote: post #116

As a radiologist I have found Claude and ChatGPT to be absolutely terrible at MRI and I would not trust it one bit. It has its merits if you need to research stuff that is more text based, but radiological images is just something that they cannot interpret good enough (yet)

AI makes up for its poor reporting by enhancing the images. Current Siemens MR software ‘Deep Resolve’ makes up the signal (adding about 50%), then makes up every second pixel, and then, for 3D sequences, makes up every second slice. It’s locking about 59% of the time off each sequences. And it’s really really good. I’m an MR tech.

but those are two different things. Of course something like Deep Resolve is great, as are modern model based reconstruction algorithms for CTs, but here we are talking about LLMs and their ability to interpret medical images, which has nothing to do with what you said.

Re: I used Claude Code to get a second opinion on my MRI

#255

Post by corndoge »

operatingthetan wrote: post #193
appplication wrote: post #55

Earlier quoted context omitted.

This is the root of AI psychosis. There’s a lot of unpack here, and I won’t go too deep because you can’t really have a discussion with affected folks because their fundamental basis is not evidence, it’s belief. It is weirdly religious in a way, because if you were to present contrary evidence (e.g. experts in a field weighing in about how plausible sounding responses are bunk), you would only be told you don’t beli…

>This is the root of AI psychosis. There’s a lot of unpack here, and I won’t go too deep because you can’t really have a discussion with affected folks because their fundamental basis is not evidence, it’s belief. Treating it as if it is an intelligence is the problem. The problem is that AI psychosis is fundamentally the belief that an LLM is "thinking" at all. Outputs are just believable word vomit which resembles…

Often times the words produced do have legitimate factual information though. It's less psychosis and more a confluence of well known human tendencies - salience bias, automation bias, etc.

Re: I used Claude Code to get a second opinion on my MRI

#256

Post by sevenzero »

rafterydj wrote: post #15

I feel like I'm going nuts. There are other commenters saying this is a good practice they've also done for other injuries. You are saying you are an actual radiologist and immediately clock the problems with its advice. I have seen this pattern over and over again. Anytime someone is an actual expert at anything, AI output appears insufficient or incomplete or outright misleading. It is only when you do not know wha…

>AI output appears insufficient or incomplete or outright misleading

It has been like this since the rise of "AI". The only people enthusiastic about it are usually the ones hoping to make a profit in one way or another.

Re: I used Claude Code to get a second opinion on my MRI

#257

Post by ruszki »

janmatejka wrote: post #205
TomasBM wrote: post #185

Earlier quoted context omitted.

Why is it psychosis and not lower standards ? While I can understand being skeptical of non-experts' claims that such answers are enough, I don't understand why you call it "psychosis" and not simply naivety or lack of expertise. At the same time, the new so-called "models" haven't been pure transformer-based LLMs, but entire systems with tools (with access to the Internet), data storage, and the options to trigger a…

Because some people develop actual psychosis. They go down some rabbit hole with an LLM until the LLM makes them believe they invented new kind of physics that makes them go harassing experts who obviously try to ignore them because its all nonsense.

For me, what others said and literally showed with Claude Code, et al, and what I’ve been experiencing with it, clearly signal way lower standards. But this was true even before LLMs.

Re: I used Claude Code to get a second opinion on my MRI

#258

Post by stringfood »

rafterydj wrote: post #15

I feel like I'm going nuts. There are other commenters saying this is a good practice they've also done for other injuries. You are saying you are an actual radiologist and immediately clock the problems with its advice. I have seen this pattern over and over again. Anytime someone is an actual expert at anything, AI output appears insufficient or incomplete or outright misleading. It is only when you do not know wha…

what is happening is that the gap between what the experts and AI know is getting smaller each year. this year sure radiologists are mocking AI's ability to interpret MRI results, but they are a lot better at that this year than last. In five years perhaps radiologists will truly appreciate AI, but I am not holding my breath because radiologists are notoriously slow to adapt to changes in medical science compared to other specialists like anesthesiologists or surgeons

Re: I used Claude Code to get a second opinion on my MRI

#259

Post by kjellsbells »

something98 wrote: post #154
rvnx wrote: post #130

Earlier quoted context omitted.

Human doctors use LLMs to diagnose too OpenEvidence claims "More than 40% of U.S. physicians use it daily, and it handled around 20 million clinical consultations per month. Over 100 million Americans were treated by a doctor using it in 2025." https://www.cnbc.com/2026/01/21/openevidence-chatgpt-for-doc...

This is a very misleading statement; most of those physicians are using LLMs to transcribe notes from visits and/or for billing purposes (e.g., proper billing codes).

The problems isnt LLMs per se, it is the shift to trusting the output of the machine coupled with a decline in verifying that the output is reasonable. It's basically what your teachers warned you about with wikipedia in eight grade except applied to all areas of life, including medicine. Dictation is already high-stakes and LLMs do not automatically reduce that risk.

Here is an example. My provider sent me this note. I'm quoting verbatim here from my MyChart record:

"Your liver enzymes are high, I would like to order acetaminophen containing medication like Tylenol, I would like to order liver ultrasound I placed ultrasound order in the system, make an appointment for radiology, I would like you to get hepatitis panel lab work done, obtain blood work order, please schedule a well visit to get it done"

When I queried it, this is what I got back. It was a dictation error. You could almost hear the panic in the message:

"Sorry for wrong message earlier, I was dictated message- so could not realize that it was written to take Tylenol type of medicines- I DO NOT RECOMMEND ACETAMINOPHEN CONTAINING MEDICINE - LIKE TYLENOL AND ALCOHOL DUE TO ELEVATED LIVER ENZYMES."

Again the problem is not dictation, or LLMs. The problem is humans ignoring their responsibility to check the output of a machine.

Re: I used Claude Code to get a second opinion on my MRI

#260

Post by yaroslavvb »

I had similar experience, Claude made report of MRI for achilles tear, it measured the gap, but it was completely hallucinated. Achilles tendon is black on the MRI, it instead measured 13mm distance between two completely different things (looked white), the radiologist looked at and saw no gap at all
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